Professional Documents
Culture Documents
ABSTRACTS
ORAL
PRESENTATIONS
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Man’s need for replacement of missing or lost body 33.3% consider the caries risk of the patient. Delton FS
parts probably existed as long as man himself. Although was the most commonly used band of sealant (40%).
social cultures have characteristically changed and the Descriptive statistics was used for this study.
accepted modalities for rehabilitation have varied
throughout the centuries, there has apparently always Conclusion
been a social awareness that the deformed body is not Dental practitioners in the city have a positive attitude
completely accepted. A considerable number of people, towards practice of pit and fissure sealants. However,
each year, acquire varying facial defects due to private practitioners have been slow to adopt sealant
malignant disease, trauma or congenital deformity. use in their practice.
Although modern plastic surgery techniques, in particular
microsurgery, can help to restore some lost tissue, in ORAL (A2 - 8)
cases of radical surgery they cannot replace the lost
part in a way which creates an acceptable illusion of THE DEFINITIVE DIAGNOSIS OF ORAL HAIRY
normal appearance. In addition, the age and general LEUKOPLAKIA IN HIV-SEROPOSITIVE AND AIDS
medical condition of the patient may also contraindicate PATIENTS.
major reconstructive surgery. In these cases a major
defect persists following surgery. These patients, Authors
Mohamed Mabruk1, Stephen Flint2, Mary Toner2 and Greg Atkins3
therefore, can be offered prosthetic rehabilitation as an
alternative to help fill this void. The specialty of Institution
Prosthodontics has grown from mere replacement of Advanced Medical and Dental Institute, University Sains Malaysia
missing teeth, to include treatment of patients with head Penang, Malaysia 1; Dublin Dental Hospital 2, Microbiology
Department, University of Dublin3
and neck malignancy, post tumor therapy surgical
reconstruction and congenital and developmental
Introduction
defects.
Oral hairy leukoplakia (OHL) is a white or grayish oral
lesion. OHL lesion, usually located on the ventral surface
ORAL (A2 - 7)
and/or lateral border of the tongue. The histopathological
features of OHL are not pathognomonic to establish a
KNOWLEDGE, ATTITUDE AND PRACTICE OF PIT
definitive diagnosis. The definitive diagnosis of OHL
AND FISSURE SEALANTS BY DENTAL
requires the demonstration of Epstein Barr virus in the
PRACTITIONERS IN KOTA BHARU, KELANTAN
OHL lesion.
Authors
Mani SA, Ahmad B Objective
To investigate the possibility of using Polymerase Chain
Institution reaction(PCR) technology in reaching a definitive
School of Dental Science, Universiti Sains Malaysia, Health diagnosis of OHL in tongue scraping obtained from HIV-
Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
seropositive patients and to compare our finding to the
conventional in situ hybridisation on OHL biopsies
Background
obtained from the same patients. Furthermore, we have
It is clearly recognized that pit and fissure sealant is an
investigated the possibility of using a rapid microwave
effective, safe and cost-effective method of preventing
in situ-hybridisation technology in order to accelerate
pit and fissure caries. Improvement in dental materials
and simplify the definitive diagnosis of OHL.
have increased retention rates and shown long lasting,
caries preventive effect. This study was done to
Methodology
investigate the use of fissure sealant among dental
Polymerase chain reaction approach was carried out
practitioners and probable factors associated with its
and compared to the conventional in situ hybridisation
usage.
method. Furthermore, we have modified a microwave
in situ hybridisation technique and designed a novel in
Method
situ hybridisation chamber to accelerate the technical
Forty questionnaires were handed out to dentists in 3
procedures for reaching a definitive diagnosis of OHL.
sectors; private practice, Ministry of health and Hospital
USM. Questionnaires were designed to evaluate
Results
knowledge of type of sealant used, attitude towards
EBV DNA was not only detected in all OHL lesional
placement of sealants and preference of type of sealant
scrapings but also in 36.3% of normal control. However,
used.
by using a conventional in situ hybridisation approach,
EBV DNA was detected only in OHL biopsies and non
Results
in the normal healthy controls biopsies. Furthermore,
An eighty percent response rate was obtained, of which
using microwave in situ hybridisation and our newly
56.3% practice the use of pit and fissure sealants in
designed chamber, we have shortened the hybridisation
their clinical practice. All dentists consider age of the
step for EBV detection in OHL biopsies, from over-night
patient prior to placing pit and fissure sealants and only
incubation to 14 minutes.
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Authors Institution
1
Nik Hazlina N. Hussain, 1Nizar Bidin, 1Che Anuar Che Yaakob, 2 1
School of Health Sciences, USM, 2Department of Obstetrics and
Md. Radzi Johari, 2Maimunah Ahmad, 3Norsaadah Bachok, 3Norlen Gynecology and 3Department of Community Medicine, School
Mohamed.
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of Medical Sciences, Universiti Sains Malaysia, Health Campus, average number of drugs per encounter, the percentage
16150, Kubang Kerian, Kelantan, Malaysia. of antibiotics prescribed per encounter and the
percentage of teratogenic drugs per encounter.
Introduction
Cervical carcinoma is the second most common cancer Results
in Malaysian women. The maximum number of drugs prescribed per encounter
was 4. Poly pharmacy was practiced in 3.89 percent of
Objective
prescriptions. Among all the prescriptions, the maximum
The study is performed to explore knowledge about
73 prescriptions had vitamin and minimum 1 prescription
cervical carcinoma and Pap smear tests among women
had analgesic. The rest 53 prescriptions had iron, 20
attending the gynaecology clinic in HUSM
prescriptions had calcium, 18 prescriptions had folic acid,
Methodology 8 prescriptions had stemetil, 7 prescriptions had antibiotic
A cross sectional study was conducted from October and 2 prescriptions had teratogenic drugs. Statistical
2003 till December 2003. Random sampling method was analysis shows that 9% early pregnant women took
used. Patients were told regarding the study and a self antibiotics and 2.5% early pregnant women took
answered questionnaire was filled up by the respondent. teratogenic drugs.
Conclusions
Result
The study found that the majority of the respondents Antibiotics and Teratogenic drugs are not indicated in
were aware of cervical carcinoma (90.3%) and had heard 1st trimester of pregnancy though these were used in
about Pap smear (86.1%). Only 33.3% of the teaching hospital. So it was highly errational. The most
respondents had a high score knowledge (21-30) on urgent need is the improvement of the rational
cancer of the cervix and 25.7% of respondents truly prescribing in early pregnancy.
appreciate the importance of Pap smear. 68.9% of
ORAL (B2 - 6)
respondents did not acknowledge the duration of which
pap smear should be carried out on a regular basis.
Further analysis revealed that majority of the information THE VANISHING TWINS PHENOMENON
of pap smear was obtained from reading materials
Authors
(48.6%). Only 6.3% of respondents obtained the Hakim G. Bilal, Awang Nila, N H Nik Hussein, Adibah, Rosilawati
knowledge of Pap smear from their husband. There is a
significant correlation between the knowledge of Pap Institution
smear with occupation (p= 0.005), education level Department of Obstetric and Gynaecology, Hospital Universiti
(p=0.001), those who had undergone Pap smear Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan,
Malaysia.
(p<0.000) and those who had heard of cancer of the
cervix (p= 0.016) and Pap smear (p<0.000). The case of a 30 year old Malay lady Gravida 3 para
2 at 6 weeks + 5 days of gestation is described. She
Conclusion
presented with a three day history of minimal per vaginal
This study showed that the knowledge on cancer cervix
bleeding but with no abdominal pain or having passed
and Pap smear is insufficient in the study group.
products of gestation. Examination showed an eight
week size uterus with the cervix long and closed and no
ORAL (B2 - 5)
adnexal abnormality.
The diagnosis first appeared to be a threatened
PATTERN OF PRESCIRIBING DRUGS IN FIRST
miscarriage then a missed abortion and then an ectopic
TRIMESTER OF PREGNANCY IN A TEACHING
pregnancy. It was not a straightforward case!
HOSPITAL OF DHAKA US showed three gestation sacs, but only one had
Author a viable fetal echo.
Z. A. Begum At just beyond six weeks of gestation, with the BhCG
levels plateauing for one week, ectopic pregnancy had
Objective also to be considered as a diagnosis.
To find-out the pattern of prescribing drugs in early Finally this case emerged as a case of “vanishing”
pregnancy twins.The pregnancy continued as a singleton pregnancy
There are many reports on the phenomenon where
Methods one gestation sac disappears from what has been a twin
A descriptive study was carried out on 77 early pregnant pregnancy. In this case however two gestation sacs have
women by their interview in a structured questionnaire disappeared from a presumed triplet pregnancy – a less
in the gynae out-patient department (GOPD), Dhaka usual “vanishing twins” phenomenon.
Medical College Hospital (DMCH), Dhaka, Bangladesh.
Data were analyzed by using the INRUD prescribing ORAL (B2 - 7)
indicators. The following parameters were studied – the
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Authors Institution
1 2 1
Surini Y. , Van Rostenberghe H. , Norlelawati A.T. , Abdul Aziz I. School of Biological Science, Universiti Sains Malaysia, 11800
1
, Noraida R.2, Isa M.N. 1, Nishio H.3 , Matsuo M.4, Narazah M. Y.1 Minden, Penang, Malaysia.
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18.083 mg/ml. Alocasia macrorrihiza was further our patients. Seventy-five % of Type I, 83% of Type II
fractioned using three different solvents i.e. hexane, and 66% of Type III patients show homozygous deletion
chloroform and 80% (v/v) methanol. Only the hexane of this gene while the NAIP gene deletion was seen in
and chloroform fractions exhibited significant cytotoxic 50% of both Types I and II and 33% in Type III.
effect on HepG2 cells with EC 50 value of 11.018 mg/ml
and 4.217 mg/ml, respectively. The chloroform extract Discussion
was subsequently fractioned and from the 17 fractions From these findings, the SMN1 gene deletion incidence
obtained, fraction F8 was considered the most potent is much lower in our population than that in other
fraction with EC50 value of 3.695 mg/ml against HepG2 populations. In addition, the NAIP gene was not related
cells. DeadEnd Colometric Apoptosis Detection System to the severity of the disease. However, it is too early to
and DNA Fragmentation ELISA indicated that the come to a conclusion with a limited number of the
chloroform extract and fraction F8 triggered the HepG2 patients. Larger scale studies are necessary to
cell death via apoptosis mechanism. determine the exact incidence of SMN1 gene deletion
in Malaysian SMA patients and to clarify the role of the
ORAL (C2 - 5) NAIP gene.
Objective
ORAL (C2 - 7) This study was designed to evaluate the frequency of
HLA-DR and –DQ alleles in ethnic Malays with SLE in
PREVALENCE OF INTESTINAL PARASITES order to determine the role of these genes in disease
AMONG SUSPECTED CASES IN HOSPITAL susceptibility.
UNIVERSITI SAINS MALAYSIA
Methodology
Authors HLA typing of fifty-five SLE patients from Malay ethnic
Al-Jashamy K. and Zeehaida M. who fulfilled the American Rheumatism Association (
ARA ) were analysed, and compared with the control
Institution
Department of Medical Microbiology and Parasitoogy, School of
group consisting of 55 healthy unrelated subject with
Science, Universiti Sains Malaysia, Health Campus, 16150, comparable age, sex and ethnic. HLA typing of class II
Kubang Kerian, Kelantan, Malaysia. antigen were carried out using MicroSSP Class II generic
( DRB/ DQB ) from One Lambda Inc.
Background
A retrospective study was conducted to review the Results
intestinal parasites cases seen in HUSM / laboratory of We found a strong significant association of HLA-DR15
parasitology. and HLA-DR17 with SLE compared to healthy control
group ( p corr = 0.002 , adjusted OR = 5.513 ; p corr =
Methods 0.04, adjusted OR = 7.87 , respectively ). There was a
During the period from January 2001 to December 2003, weak decrease of HLA-DR4 which was not significant
all the cases were recorded. The stool samples were after corrections for multiple comparisons made.
microscopically examined for intestinal parasites using
the formalin-ether concentration technique. Conclusion
Our data suggests the role of the HLA Class II genes in
Results conferring SLE susceptibility and in clinical expression.
A total of 4588 stool samples were collected from the
patients who were suspected to have a parasitic ORAL (C2 - 9)
infection. Overall infection rate was 11% (530 out of 4588
samples), with Ascaris lumbricoides (3.8% or 174 cases) AN OUTBREAK OF PANTOEA SPP. IN A
and Trichuris trichiura (3.8% or 173 cases) as the NEONATAL INTENSIVE CARE UNIT (NICU)
commonest parasites. The positivity of Blastocystis SECONDARY TO CONTAMINATED TOTAL
hominis was 1% (50), Entamoebia histolytica 1% (46), PARENTERAL NUTRITION (TPN).
Giardia lamblia 0.8% (38), Hook worm 0.7% (33),
Stronyloides and Entrobius vermicularis were 0.2% and Authors
0.01% respectively. Overall positivity rate in 2001 was Habsah H*, Zeehaida M*, Rosliza AR*, Van Rostenberghe H**,
13% which was higher than in 2002 (11%) and 2003 Noraida R**, Wan Pauzi WI**, Fatimah I**, Nik Sharimah NY**
(11%). Conclusions: The overall positivity rate indicated Maimunah H***
that the parasitic infection rate was less in 2002 and
Institution
2003 than 2001 using the same technique. * Department of Medical Microbiology and Parasitology, **
Department of Pediatric, PPSP, Infection control and Hospital
ORAL (C2 - 8) Epidemiology Unit HUSM, Universiti Sains Malaysia, Health
Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
HLA CLASS II ANTIGENS IN MALAYS WITH
Background
SYSTEMIC LUPUS ERYTHEMATOSUS IN HUSM
Neonates are particularly susceptible to infection
Authors because their immune system is not fully developed. In
Nurul Khaiza Y1, Nadeem A1, Kamaliah MD2. addition, they often require invasive diagnostic and
therapeutic procedures that are associated with an
Institution increased risk of infection. An important source of
1
Department of Immunology, 2Department of Medical, School of
Medical Sciences, Universiti Sains Malaysia, Health Campus,
infection is contaminated parenteral nutrition. Pantoea
16150, Kubang Kerian, Kelantan, Malaysia. spp. rarely cause infection in immunocompetent hosts
and has never been reported to cause mortality or severe
Background morbidity. The objective of the study is to investigate an
Systemic lupus erythematosus ( SLE ) is a disease of outbreak caused by Pantoea spp. in a neonatal intensive
abnormal immune regulation, characterized by the care unit.
production of autoantibodies. Autoantibody production
depends on the interaction of helper T lymphocytes with Methodology
HLA Class II molecules on antigen presenting cells; A descriptive study of an outbreak of sepsis in NICU,
therefore, the class II genes have a role in susceptibility HUSM. Pantoea spp. infection was detected in eight
through alteration of T cell recognition. patients during three-days period from 24 th to 27 th
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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN
January 2004 following the administration of TPN. Seven living in a rental house were significant risk factors
of eight patients died due to the infection. An extensive associated with adult’s admissions at GHP for poisoning.
environmental sampling and culture were done including Other significant risk factors included study, family,
in-use TPN and other unused TPN in NICU and marital and boy/ girl friend problems.
pharmacy during the outbreak period.
Conclusions
Results This study has identified risk factors can be used as a
Pantoea spp. was isolated from blood cultures of guide for targeting poison control programs.
infected patients, the unused TPN from pharmacy and
also from the unused TPN from NICU. All the strains of ORAL (A3 - 2)
Pantoea spp. had the same antibiotic susceptibility
pattern and biochemical reaction. MENINJAU KEHADIRAN MIKROORGANISMA
PADA ALATAN GALIPOT DAN CECAIR YANG
Discussion and Conclusion DIGUNA SAMA UNTUK PROSEDUR SEDUTAN
The source of the outbreak was the TPN and the TIUB ENDOTRAKEA DAN TIUB TRAKEOSTOMI.
contamination occurred during the preparation of TPN
in pharmacy. A thorough investigation has been carried Authors
out and where possible corrective measures have been Anisah binti Mat Desa, Farid bin Che Ghazali,
taken to avoid similar outbreaks in the future.
Institution
Pusat Pengajian Sains Kesihatan, Universiti Sains Malaysia,
ORAL (A3 - 1) Kampus Kesihatan, 16150, Kubang Kerian, Kelantan, Malaysia.
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predict the outcome. Currently, it is believed that the smoking and stroke death in a representative Japanese
permanent outcome of the patient can be predicted from population.
a follow-up CT scan of brain as early as six weeks.
Methods
Objective and Methods A total of 9,638 men and women aged 30 years and
The aim of this study is to predict the outcome of the older without a history of cardiovascular disease (CVD)
adult patients with moderate and severe head injury in at baseline in 1980 were followed for 14 years. Follow-
motor vehicle accident by using clinical parameters (age, up rate was 91.4%. Causes of death were ascertained
Glasgow Coma Scale), initial CT scan of brain parameter from National Vital Statistics. Cox proportional hazard
(intracranial haemorrhage, volume and site of intracranial ratios were calculated adjusting for age, systolic blood
haemorrhage, midline shift and hydrocephalus) and pressure, and other conventional risk factors.
follow-up CT scan of brain parameter (residual
intracranial bleed, post-traumatic hydrocephalus, midline Results
shift and gliosis). The patient is assessed clinically on We observed 203 stroke deaths (107 cerebral
admission for GCS. Those categorised into moderate infarctions, 45 cerebral hemorrhages, and 51 others),
and severe head injury with initial and follow-up CT scan 191 heart disease deaths, and 413 CVD deaths. The
of brain 6 weeks later will be selected for the study. The average serum total cholesterol level was ~4.91mmol/
parameters were analyzed statistically using univarite L. The hazard ratios for men who smoked 1-20
analysis, chi square test and logistic regression. The p cigarettes/day on all strokes, cerebral infarction, and
value of < 0.05 is taken as significant level. cerebral hemorrhage were 1.60 (95% confidence interval
(CI), 0.91-2.79), 2.97 (CI. 1.27-6.98), and 0.42 (CI. 0.16-
Results 1.09), respectively, and for those who smoked ≥21
A total of 31 patients were selected, 67.7% are male cigarettes/day, they were 2.17 (CI. 1.09-4.30), 3.26(CI.
and 32.3% are female. The GCS of the patients were 1.11-9.56), and 0.68 (CI. 0.20-2.33), respectively. For
statistically significant as outcome predictors. Other women who smoked ≥21 cigarettes/day, the hazard ratio
significant predictors analyzed from the study are midline for all strokes was 3.91 (CI 1.18-12.90). For CVD, all
shift and volume of subdural haemorrhage in the initial heart disease, and ischemic heart disease, the hazard
CT scan and post-traumatic hydrocephalus and gliosis risks of smoking were significant (1.49 to 4.25) for men
in the follow-up CT scan. but not significant for women.
Conclusion Conclusions :
The study showed that the above-mentioned parameters Smoking in a cohort with moderate serum total
are significant predictors of outcome. The author also cholesterol level was a potent risk factor for stroke,
have suggested a new outcome predictors by using the especially cerebral infarction, for both men and women,
parameters from follow-up CT scan i.e. presence of and CVD and ischemic heart disease for men.
gliosis, site of gliosis and post-traumatic hydrocephalus.
ORAL (A3 - 8)
ORAL (A3 - 7)
DIAGNOSTIC VALUE OF ECG CHANGES,
CIGARETTE SMOKING AS A RISK FACTOR FOR ARRHYTHMIA AND CHEST PAIN DURING
STROKE DEATH IN JAPAN: NIPPON DATA 80 DOBUTAMINE STRESS MYOCARDIAL
PERFUSION IMAGING
Authors
Ueshima H1, Choudhury SR2, Okayama A3, Hayakawa T4, Kita Y1, Authors
Kadowaki T1, Okamura T1 and NIPPON DATA80 Research Group Tuhin H1, Zurkurnai Y2, Sapawi M2, Tee MH2.
Institution Institution
1
1
Department of Health Science, Shiga University of Medical Department of Nuclear Medicine, Radiotherapy and Oncology,
2
Science, Otsu, Japan. 2Department of Community Medicine, Department of Medicine, School of Medical Sciences, Universiti
School of Medical Sciences, Universiti Sains Malaysia, Health Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan,
Campus, 16150, Kubang Kerian, Kelantan, Malaysia. Malaysia.
Introduction Background
Some previous Japanese cohort studies failed to show The presence of myocardial perfusion abnormalities
an association between smoking and stroke risk. Since assessed by dobutamine stress myocardial perfusion
such an association has been noted in other populations, imaging (MPI) accurately diagnoses patients with
this issue should be re-examined in a recent coronary artery disease, and are powerful predictors of
representative Japanese cohort with a higher total cardiac events. Thus, results of this imaging modality
cholesterol level. help in selecting the appropriate management strategies.
During dobutamine stress test, ECG changes,
Objectives arrhythmia and chest pain occur frequently. However,
To investigate the association between cigarettes data regarding diagnostic value of these parameters to
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predict myocardial perfusion abnormalities are scarce. calculated from the MRI study. The volume change is
Thus, the aim of this study was to determine the correlated with patients’ clinical progress as assessed
diagnostic value of ECG changes, arrhythmia and chest by the treating psychiatrist.
pain to predict myocardial perfusion abnormalities on
SPECT. Results
Seven patients came for the initial MRI while only four
Method came for the second MRI. About 13 – 25 % increase in
We performed dobutamine-atropine stress 99Tcm- volume of hippocampal complex was found following
tetrofosmin/MIBI myocardial perfusion SPECT in 26 treatment. It correlated with the patients’ progress of
patients referred to the department of nuclear medicine illness.
for MPI. SPECT imaging was performed 30 min post-
injection using one-day stress-rest protocol. Conclusion
The result shows that there is increase in hippocampal
Results complex volume following treatment which correlates
Myocardial perfusion abnormalities (reversible or fixed with the patients’ clinical improvement. In future, this
defects) were detected in 11(42.3%) out of 26 patients. finding can aid in assessing clinical response in major
The sensitivity and specificity of ECG changes (ST depression patients treated with SSRI drugs.
depression, ST elevation or T wave normalization) to
predict myocardial perfusion defects were 45.5% and ORAL (A3 - 10)
86.7% respectively. The sensitivity and specificity of
cardiac arrhythmia (significant supraventricular or INSULIN SENSITIVITY STATUS OF NON-OBESE
ventricular arrhythmia) were 45.5% and 86.7%,and of NORMOGLYCEMIC MALAY SUBJECTS :
chest pain were 18.2% and 80% respectively. RELATIONSHIP BETWEEN INSULIN SENSITIVITY
AND LIPID STATUS.
Conclusion
ECG changes, cardiac arrhythmia and chest pain during Authors
dobutamine stress test showed high specificity. However, A. Kholdun Al-Mahmood, A.A. Ismail, Faridah A. Rashid, WB Wan
Mohammed, Sohel R. Choudhury, Nor Azwany Yaakob
the low sensitivity of these parameters warrants
performing dobutamine stress test in conjunction with a Institution
more sensitive imaging modality such as MPI. School of Medical Sciences, Universiti Sains Malaysia, Health
Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
ORAL (A3 - 9)
Introduction
VOLUME OF HIPPOCAMPAL COMPLEX IN Hyperlipidaemia and insulin resistance has a complex
MAJOR DEPRESSION PATIENTS BEFORE AND relationship. Most of the previous studies were looking
AFTER TREATMENT WITH SELECTIVE at insulin resistance in hyperlipidaemic subjects who
SEROTONIN REUPTAKE INHIBITOR (SSRI) were also obese. So influence of obesity and
hyperlipidaemia acted simultaneously in the genesis of
DRUGS
insulin resistance.
Authors
Magendiran A/L Shummugam; Hj. Mohd Shafie Abdullah; Mohd Objective
Najib Alwi; Win Mar @ Salmah Jalaluddin The present study was designed to determine insulin
sensitivity and secretory status of non-obese
Institution
normoglycemic subjects, and to find out the relationship
Department of Radiology, Hospital Universiti Sains Malaysia,
Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia. between hyperlipidemia and insulin sensitivity in a non-
obese population.
Purpose
To assess change in volume of the hippocampal complex Methodology
in major depression patients following treatment with A cross sectional study on 74 non-obese (BMI<25, waist
SSRI drugs. This is correlated with progress of the circumference male<102cm, female <88cm.) and non-
patients’ illness. To date no other institution has done diabetic subjects age between 30-60 years was carried
this study on humans. Similar studies on rats showed out. The subjects underwent OGTT, LFT and RFT to
hippocampal volume increase of about 70 %. exclude type 2 diabetes, IGT, IFG, renal and liver
diseases. Fasting plasma glucose, fasting insulin and
Method lipid profile were done. Insulin sensitivity and secretory
Newly diagnosed untreated major depression patients status was calculated using homeostasis model
fulfilling the study criteria are selected. First MRI of the assessment (HOMA) software (HOMA%S, HOMA%B
brain done for the hippocampal complex structure. and HOMA-IR). The subjects were devided into two
Patients start consuming the SSRI drugs after the MRI. group according to their lipid status and their insulin
After six months, the MRI study is repeated following sensitivity was compared by MannWhitney test.
similar protocols. The hippocampal complex volume
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Institution Introduction
Department of Oftalmology & Pathology, School of Medical Inverted papillomas are slow growing, most commonly
Sciences, Universiti Sains Malaysia, Health Campus, 16150,
Kubang Kerian, Kelantan, Malaysia.
benign neoplasms of the sinunasal tract. However their
three characteristic features, a tendency to recur, a
Objective destructive capability for the surrounding structures and
To compare the conjunctival surface morphology that an association with malignancy make them distinct from
develops with the use of topical timolol maleate 0.5% other benign neoplasm of this region.
and topical latanoprost 0.005%.
Methodology
Method 19 operated patients for inverted papilloma were followed
Newly diagnosed glaucoma patients are randomly through hospital records. Besides demographic data the
divided into 2 groups by closed envelope method: morbidity of the disease at the time of presentation was
noted. The types and extent of surgical procedures were
Group 1 : treated with topical timolol maleate 0.5% critically evaluated for their morbidity and control of signs
Group 2 : treated with topical latanoprost 0.005% and symptoms.
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Conclusion Institution
En block removal of medial wall of maxilla along with Department of Otorhinolaryngology-Head & Neck Surgery, School
partial removal of ethmoids through a lateral rhinotomy of Medical Sciences,Universiti Sains Malaysia, Health Campus,
approach is a comfortable and satisfactory procedure 16150, Kubang Kerian, Kelantan, Malaysia.
in the management of inverted papilloma.
Introduction
Deafness present at birth or arising early in life, is one
ORAL (B3 - 8)
of the most serious long-life handicaps from which a
human being can suffer. Prevention, early identification
CENTRAL CORNEAL THICKNESS AND
and early rehabilitation can prevent the ‘social and
INTRAOCULAR PRESSURE AMONG MALAY
communication’ isolation. Severe deafness is present
UNDERGRADUATES OF HEALTH CAMPUS,
in every 1 person of 750 population. About 50% of cases
UNIVERSITI SAINS MALAYSIA. of deafness are of unknown aetiology.
Authors
Mohd Aziz H, Liza Sharmini AT, Mohtar I Objectives
1. To identify the aetiologic/high risk factors among
Institution hearing impaired (sensorineural deafness) children
Department of Ophthalmology, School of Medical Sciences, 2. To determine the possible preventable aetiologic
Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,
causes and its preventive aspects
Kelantan, Malaysia.
3. To define the problems resulting to non-compliance
Objective and failure of rehabilitation
To study the correlation between central corneal
thickness and intraocular pressure among Malay Methodology
undergraduates of Health Campus, USM. Training of health clinic personnels in Kelantan (110
nurses) and centrally in KL (30 nurses) was done to
Methodology identify children early (using distraction test of hearing).
A cross sectional study was conducted in 130 subjects. Hospital and clinic staffs were made aware of high risk
Central corneal thickness was measured with non- factors and referrals and appointments were fascilitated
contact Topcon SP2000P specular microscope (Topcon in order to accommodate for the new cases. Hearing
Corp, Japan). Intraocular pressure was measured by Screening was also done in the Special Care Nursery,
Goldman applanation tonometer. Each parameter was and later extended to other newborns in the maternity
repeated for three times by the primary investigator to ward. A community based screening for ear and hearing
get an average reading. All measurements were disorders was also done in the district of Tumpat among
performed between 3 and 5 pm. 2,004 people. The number of new cases has significantly
increased during the study period for e.g. from 271 in
Results year 2000 to 512 cases in 2001. From Jan 2000- Dis
There is a strong positive correlation between intraocular 2001, there were 783 new referral to the clinic and out
pressure and central corneal thickness (r=0.467, p< of that, 75 were diagnosed to have sensorineural hearing
0.01). Linear regression analysis showed a b1 value of loss
0.0408 (p< 0.01).
Results
Conclusion In 36.7% of patients (27/75) they were diagnosed earlier
Central corneal thickness may influence measurement and 63.7% were diagnosed late (more than 3 years old).
of intraocular pressure made by an applanation The average age af diagnosis is 4.6 years. The most
tonometer. In this study, we observed that there is an consulted high risk factor is family history (21.3%),
estimated 4 mmHg increased in intraocular pressure for prenatal infection (TORCHES) (6.6%), another 6.6% had
every 100 micron increase in central cornel thickness. exposure to ototoxic drug and 6.6% with ventilation more
The thickness of the central cornea should be considered than 10 days. In 40% no known aetiological in risk factors
when intraocular pressure is measured using an are found.
applanation tonometer.
Discussion
ORAL (B3 - 9) Many of the possible etiological risk factors are
preventable e.g. exposure to ototoxic drug, prenatal
A STUDY OF THE HIGH RISK FACTORS FOR infection, hiperbilirubinaemia and meningitis, and steps
DEAFNESS AND PROBLEMS OF should be taken approximately. The average age af
REHABILITATION AMONG THE DEAF CHILDREN diagnosis is 4.6 years, which is very late where the
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Institution
Introduction
Department of Oftalmology & National Bank Tissue, School of
Sea cucumber or better known as ‘gamat’ by the local Medical Sciences, Universiti Sains Malaysia, Health Campus,
Malaysian people possesses high nutritional value and 16150, Kubang Kerian, Kelantan, Malaysia.
is widely used as a traditional medicine. Fungal corneal
ulcers although considered rare in occurrence, usually Objective
results in devastating complications and blindness. The To compare recurrence rate between air-dried amniotic
treatment of fungal ulcers is still not satisfactory due to membrane graft and bare sclera technique for primary
limited availability of antifungal drugs owing to their pterygium excision.
restricted market value. Due to this, the treatment is
very costly and often very toxic to the eyes and also Method
systemically Primary pterygium patients were randomized into 2
groups by closed enveloped method:
Objectives Group A: pterygium excision with air-dried amniotic
To determine the inhibitory effect of ‘gamat’ and the membrane graft
minimum inhibitory concentration (MIC) of ‘gamat’
extracts against Aspergillus fumigatus.and to assess the Group B: pterygium excision with bare sclera technique.
antifungal effects of ‘gamat’ in Aspergillus-induced Post-operative pterygium recurrence were compared
keratitis in rabbits. within 7 months follow-up.
Methods Result
Methanolic extract of Stichopus chloronatus was used 1) In amniotic membrane group, the pterygium
to prepare eye ointment based on its inhibitory effects recurrence rate was 19.2%. The recurrence rate in
and MIC value. Aspergillus-keratitis was induced in both bare sclera was significantly higher, 60.7% (p=0.02).
eyes of 7 New Zealand White rabbits’ cornea and treated However fibrous tissue (grade 3 appearance) was
randomly with ‘gamat’ extracts and placebo. Daily clinical seen more in amniotic membrane group at 7 months
examination of ocular infection was recorded. of follow-up (31.1%) compare to bare sclera group
(13.3%)
Results 2) The significant difference for recurrence between
The largest inhibition zone (average =18.2 mm) was these 2 groups can be seen as early as 5 months of
observed when ‘gamat’ extract was dissolved in follow-up. 3) There was no significant difference
chloroform compared to other solvents. The MIC value between recurrence and age or sex
of 1.562 mg/ml was recorded in serial dilution of the
extracts using disc diffusion method on Aspergillus Conclusions
fumigatus. Six rabbits were enrolled in the clinical control The relatively low recurrence rate for post pterygium
trial. Inoculation of fungus was successful in all six excision allows one to use air-dried amniotic membrane
rabbits. Daily clinical examination showed variable graft as an alternative for pterygium surgery. However
degree of infectivity and response. Colony count at the longer follow-up might revealed higher recurrence rate
end of five days of treatment with ‘gamat’ and placebo in this technique as well?
showed no significant difference in means between the
two groups (p > 0.05). Limitations of this study and ORAL (B3 - 12)
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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN
LONG TERM VISUAL OUTCOME IN DIABETIC 18) in 6 patients bilaterally (12.5%) and 27 patients
RETINOPATHY AFTER LASER unilaterally (56%).
PHOTOCOAGULATION THERAPY
Conclusion
Authors Sight threatening conditions of diabetic retinopathy if
Rajesh K Khanna, Puneet Agarwal treated early by laser therapy, can delay or halt the
progression of retinopathy with stabilisation of vision.
Institution
Department of Oftalmology, School of Medical Sciences, Although, control of diabetes remains the most important
Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, factor in preventing visual impairment along with other
Kelantan, Malaysia. complications.
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guidance from subject specialists and well-prepared in fact an illumination of perceptions in pertinent issues
facilitators of the sessions were beneficial. The students regarding the tutors’ roles and indicates the importance
believed that repetition of triggers from year to year of taking specific strategies for both tutors and students
discouraged their active search for learning issues. They with different backgrounds.
also reported that there was not enough learning
materials made available for their self-study. ORAL (C3 - 4)
Institution
ORAL (C3 - 3) Department of Medical Education, School of Medical Sciences,
Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian,
THE EFFECTIVENESS OF THE ROLE OF PBL Kelantan, Malaysia.
TUTORS: USM STUDENTS’ PERCEPTIONS
Objective
Authors To explore the opinion of the doctors about the reasons
A.T.M. Emdadul Haque; Rogayah Ja’afar; Ahmad Fuad Abdul and factors for not being interested to serve the rural
Rahim health complex
Institution
Department of Medical Education, School of Medical Sciences, Introduction
Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, The health care system of Bangladesh is developed
Kelantan, Malaysia. around primary, secondary and tertiary level. At the
primary level the health care services are provided by
Background Upazilla health complex (UHC) and union sub-centers
In problem-based learning strategy, the roles of PBL (USC). There is considerable evidence that, basic health
tutors are crucial that involves the facilitation of an active care does insufficiently reach the majority of the
learning process and fostering the skills of critical thinking population of the country. Different studies showed that
and habits of continued learning rather than to convey the service of UHC is underutilized. There is always
knowledge, but requires special skills and training. It is criticism from different corners of the country and in
anticipated that the ideal PBL tutor will be a group newspapers that the doctors are not interested to serve
facilitator rather than a subject matter expert. Students’ the rural health centres. The study was intended to find
evaluation of tutors is also found to be effective for faculty out the actual facts and reasons that are responsible for
development. This study was carried out at USMKK to poor motivation and a lack of interest among the doctors
investigate students’ perceptions regarding the to serve the community.
effectiveness of the role of PBL tutors.
Methodology
Methods A cross sectional qualitative study was carried out among
Based on all aspects of tutors role and area of expertise, medical doctors. A pre-tested self-administered
a questionnaire was developed. The items were scored questionnaire was distributed to 400 randomly selected
on a 5-point Likert-type scale and ratings were distributed doctors working in secondary and tertiary level hospitals
as strongly agree (1) to strongly disagree (5). The in Bangladesh
students from all the PBL groups in phase-II of 2003-
2004 sessions were included in this study. Results
Out of the 400 questionnaires 357 were returned; the
Results response rate was 87.5%. Among the respondents 81%
The students’ perception on tutors’ role significantly had working experience at UHC/USC level from 1 to 8
changed towards positivity in some areas across the years. Though the majority of them had work experience
year of their training. Among different races, Malay at UHC/USC level but they did not like to stay and serve
students rated best that significantly differed with others. the rural health centers. The main identified factors were
There was also significant difference in ratings between a) lack or irregular supply of proper medicine at the
genders. It was seen that non-clinical tutors were rated centres, b) lack of proper accommodation, c) lack of
better, but it didn’t differ significantly between tutor types. proper school facilities for the children, d) minimum
recreation facilities and e) minimum scope for
Conclusion professional development. Non co-operation from senior
Students’ feedback is an important exercise for colleagues (48%), interference by local administration
improvement of tutor skills, so tutor evaluation can be (81%) and political leaders (84%) in UHC/USC activities
adopted as a part of PBL tutorial process. This study is
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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN
were also identified by the respondents as major 0.82 for the domains of A; and 0.70 for the P. Factor
prohibiting factors. 75% of the respondents also felt that analysis also revealed that selected items were
our undergraduate medical curriculum could not motivate appropriate in their corresponding domains.
students to serve the rural health centres. The
respondents mentioned that a) specific time duration for Conclusion
rural health service, b) special facilities for higher studies, The final version was considered short and accurate in
c) special facilities for promotion and d) provision of terms of content validity, construct validity and internal
incentives in different form might improve the situation. consistency reliability.
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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN
is boring as the tutor is boring, tutor is not friendly and eliminate obstacles and create conducive working
didn’t stimulate and guide properly, tutor is not attentive, environment for the female surgeons, so that they would
not experienced and not well facilitating, don’t use “X” be able to combine productive careers with rewarding
tutor as guide. family lives.
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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN
Discussion Results
This study indicated that students’ expectations and Symptoms of lethargy, sleepiness, sudden wakefulness,
experiences were positive towards the use of handouts. forgetfulness, stress, confusion, irritability, headache,
They used handouts as a means of supplementing rather vertigo, palpitation, excessive sweating and numbness
than substituting their learning. Much care is needed noted more when there was high level of blood lead
when educators supply computer-based handouts, as and recognized among car spray painters and car
this study shows some limitations when students use mechanics. Mean blood lead level among car spray
them. Medical schools should consider publishing web- painters was 10.19 µg/dl and significantly higher as
based handouts with online and other facilities to make compared to car mechanics was 7.39 µg/dl (p=0.01).
it interesting and effective. Mean environmental lead level inside the car spray and
painting chambers was 8.07 µg/m_ and slightly lower
ORAL (C3 - 12) than environmental lead level around services and
repairing areas which was 8.58 µg/m_.
NEUROBEHAVIOURAL PERFORMANCES IN CAR Neurobehavioural symptoms, neurobehavioural
SPRAY PAINTERS AND MECHANICS EXPOSED performances and environmental lead levels were not
TO ENVIRONMENTAL LEAD IN KOTA BHARU, significantly different between car spray painters and
KELANTAN mechanics. Also noted mean blood lead levels of car
spray painters and car mechanics were higher as
Authors compared to other group of occupation in Malaysia.
*Mohd Nazhari M.N., Rusli N. dan Abu Hassan Shaari A.K. Although environmental lead levels around car servicing
and maintaining areas were slightly higher than inside
Institution car spraying chamber, it actually not showing the true
*Department of Community Medicine, USM dan Ministry of Health
exposure and what actually needed was the personal
Introduction air sampling.
Lead exposure poses a major public health hazard and
Conclusion
is recognized as the most prevalent and preventable
Car spray painters had significantly higher in blood lead
health issue in many industrialized countries. Lead-
level as compared to car mechanics. However,
based paint poisoning, a well recognized entity among
neurobehavioural symptoms, neurobehavioural
young children in poor, urban neighbourhoods, is not
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ABSTRACT, 9TH NCMS, 22 - 23 MAY 2004, UNIVERSITI SAINS MALAYSIA, HEALTH CAMPUS, KUBANG KERIAN, KELANTAN
Authors
Mohd Jamil Yaacob, Naliza Zulkifli, Mark Newman1, Nick Goddard2
Institution
School of Medical Sciences, Universiti Sains Malaysia, Health
Campus, 16150 Kubang Kerian, Kelantan, Malaysia; 1St. Bunstan’s
College, London; 2Lewisham South East, London.
Objective
A cross-cultural study was conducted in United Kingdom
(UK) and Malaysia to look at the patterns of friendship
and self-esteem among adolescents aged 13-16 with
respect to age, gender, race and length of friendship.
Methodology
All Year 10 (St Dunstan’s College students in UK) and
Form 2 (King George V Secondary School in Malaysia)
were included. A total of 198 pupils from both schools
were recruited but only 168 were chosen for final
statistical analyses using SPSS and EQS computer
programme. The 46-item Friendship Qualities Scale and
11-item Rosenberg Self-esteem scale were translated
into the Malay language and were subjected to validity
and reliability studies using confirmatory and exploratory
factor analyses. Cross-cultural comparison was made
using non-parametric tests based on compatibility scales
between the two cultures.
Result
Friendship varied between St Dunstan’s and King
George V but not self-esteem. Girls had higher friendship
qualities but lower self-esteem in St Dunstan’s but on
the other hand, boys had higher friendship qualities but
lower self-esteem in King George V. Race differed with
self-esteem in St Dunstan’s but it differed with friendship
in King George V. Length of friendship did not differ with
friendship and self-esteem in both places.
Conclusion
Contemporary discovery in cross-cultural psychology
indicates that there are different paths of development
in the West as compared to the East. In UK, the path is
one of individual maturation that result in higher self-
esteem scores as compared to friendship qualities. In
Malaysia, the path is one of symbiotic group maturation,
as shown in higher friendship qualities scores as
compared to self-esteem.
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